These States Would Be Completely Devastated If Obamacare Is Repealed

Protesters in Kentucky fight against the Affordable Care Act repeal, which would result in people losing health insurance coverage. | Bill Pugliano/Getty Images

Repeal Obamacare: It’s the battle that never seems to end. Though Republican efforts to “repeal and replace” the Affordable Care Act so far have been unsuccessful, Trump and company have vowed to keep it up. What we do know is it would have a disastrous effect for millions of Americans.

Republicans failed to pass an alternative health care plan in the House. But they took a dead bill, reanimated it, and managed to pass it by a couple of votes. Similarly, we could see something in the Senate. The Senate bill also appears to be dead, even with amendments. But there’s always the chance it could spring back to life. Or Republicans could throw caution to the wind and simply vote to repeal Obamacare without a replacement.

That would really throw everything into a tailspin. But they could do it; they have the numbers. It’s all a matter of persuading a handful of key senators at this point. So even though the “repeal and replace” concept looks dead, it’s best not to rule anything out.

And in the event that Republicans do manage to move forward, the Urban Institute has published an analysis that details which states would see the biggest impact. Part of the report shows where the uninsured rate would climb and by how much, on a state-by-state basis. We’ll go through the top 15 on the following pages. The analysis shows nationwide the ranks of the uninsured would rise 78%. But in some states, it would be considerably more.

The report looks at the Republican Senate plan — the Better Care Reconciliation Act — prior to the “Cruz amendment.” Jargon aside, here’s where a lot of people would lose health coverage if the Affordable Care Act is replaced with this Republican plan.

15. Washington

No corner of the country would escape the culling unscathed. Case in point: the state of Washington. Though the Pacific Northwest is a long way from states, such as Kentucky, which are often the focal point of the health care fight, folks in Washington would be hit hard, too. According to the Urban Institute, the uninsured rate in the state could jump more than 144.1% under a “repeal and replace” scenario.

It’s not just blue West Coast states, though. Blue East Coast states would also feel the sting.

14. New Jersey

The skyline and the Atlantic Ocean in Atlantic City | iStock.com/AppalachianViews

While New Jersey’s governor takes in the sights and enjoys sunny days at the beach, many of the state’s residents would need to worry about their health insurance. According to the data from the Urban Institute’s analysis, the uninsured rate would jump 149.7% by 2022 if the Affordable Care Act is repealed. While an increase of almost 150% is alarming on its face, it’s still nothing compared to what some other states are dealing with.

One of those states? It’s home to Bernie Sanders, a champion of nationalized health care.

13. Vermont

Montpelier, Vermont | City of Montpelier, Vermont, City Government via Facebook

Vermont is another deep blue state that could see a disastrous scenario unfold if the health insurance markets are thrown into chaos. It’s a rural state with a relatively small population — one of those states that largely benefit from the Affordable Care Act’s framework. And without it, or under the current Republican proposal, a lot of people would suffer. The data anticipated a 168.6% jump in the uninsured rate in Vermont by 2022.

Speaking of rural states, the next one on the list is as rural as it gets.

12. New Mexico

Albuquerque, New Mexico | iStock.com/alex grichenko

Imagine what it would be like if Heisenberg was after your health insurance? That’s roping in a fictitious character on top of a hyperbolic scenario, of course. But for many folks in New Mexico, it might feel like their health insurance is in serious danger. And it is. If Republicans manage to pass their Senate bill, the number of people without insurance in New Mexico could increase by as much as 175.6%.

One of the great ironies of Trump’s election is his policies do the most damage to those who helped elect him. Case in point? Ohio.

11. Ohio

Ohio Gov. John Kasich speaks at a rally. | Jeff Swensen/Getty Images

The state of Ohio was one of a handful that swung the 2016 election to Trump. And health care policy was a big part of that. Though Ohio’s Republican governor, John Kasich, has adopted the policies to help the people of his state, repealing Obamacare would set them several steps back. The analysis predicts Ohio’s uninsured would increase 178.1% by 2022.

We’re not finished with blue states, though, not by a long shot.

10. Oregon

Mt. Hood | Craig Mitchelldyer/Getty Images

Oregon isn’t really one of those states you think would be imperiled by the Senate health care bill. But here it is, among the top 10 on the Urban Institute’s analysis. Per that report, Oregon’s uninsured ranks could increase by 179.8% by 2022 with the passage of a Republican health care law. That’s higher than it’s northerly neighbor, Washington, but is still dwarfed by the predictions for other states.

Next we go back to the East Coast where another blue state is imperiled.

9. Connecticut

Downtown Hartford, Connecticut | Thinkstock

Connecticut is yet another state that tends to vote Democrat come election time. And, like the other blue states we’ve already discussed, it’s in trouble if Senate Republicans can resurrect and pass a bill that Trump would be all too happy to sign. The Urban Institute says Connecticut’s uninsured would increase 180.7% by 2022 if that series of events were to unfold.

Connecticut’s neighbor to the east would suffer a similar fate.

8. Rhode Island

Providence, Rhode Island | iStock.com

You’ll notice there’s a strong showing from New England on our list. That includes Rhode Island, a state that is very close, geographically speaking, to Connecticut, Vermont, and the state we’ll jump to on the next page. The Urban Institute’s analysis predicts the number of people without health insurance in Rhode Island would jump 189.9% with the passage of the Better Care Reconciliation Act.

We said more New England was on tap, and here it comes.

7. New Hampshire

An outdoor scene in New Hampshire | Joe Raedle/Getty Images

If you guessed New Hampshire, give yourself a pat on the back. New Hampshire is another one of those swing states (albeit a smaller, less consequential one) that tends to be a political battleground. When it comes to health care, though, it could be in trouble if Senate Republicans get their way. The report shows the number of uninsured people would increase 192.5% under the act.

We’re not done with swing states, folks.

6. Michigan

A factory on the Michigan shore | Scott Olson/Getty Images

Michigan wasn’t really considered a swing state in 2016. But everyone was wrong about that as the state ended up swinging for Trump — one in a series of Rust Belt states that tipped the election. And it’s also one that could see disastrous consequences in terms of health care policies. The ranks of the uninsured in Michigan could grow by 192.6% under Republican plans.

We’ll move right along down the Rust Belt for our next state.

5. Pennsylvania

A Pennsylvania resident | Mark Makela/Getty Images

We’ve covered Michigan and Ohio, and the trio wouldn’t be complete without Pennsylvania. It’s another state that surprised everyone and voted for Trump in 2016. And like Michigan and Ohio, it could end up hurting the state’s residents in terms of health insurance coverage. The Urban Institute analysis predicts the number of uninsured people in Pennsylvania could go up 193% by 2022.

Next up, we head to the South.

4. Arkansas

Sen. Tom Cotton visits Arkansas. | Justin Sullivan/Getty Images

Arkansas is in serious trouble if Republicans pass their bill. The Urban Institute predicts a jump in the ranks of the uninsured as high as 196.2% — the biggest increase of any states in the South. In fact, it’s by far and away larger than any other state in the region by several magnitudes. It’s all a big “if,” though, regarding whether the new policy will pass.

The nation’s capital, despite lacking statehood, won’t be immune to any policy changes.

3. Washington, D.C.

The Washington Monument | iStock.com/SeanPavonePhoto

Most people don’t think of how federal policy changes impact those living in the nation’s capital city. But it does, and it will, particularly when it comes to health care policy. The Urban Institute shows a predicted increase of 205.8% should Republicans sign their plans into law. Those same Republican legislators, of course, would be exempt from the changes. Or at least they tried to put in a workaround.

Take a whack, and see whether you can guess the final two states on our list.

2. Kentucky

Kentucky is a state that has been at or near the center of the health care debate for many years now. Parts of Kentucky benefited more from Obamacare than any other place in America, seeing the sharpest decline in the number of uninsured persons. But if the Affordable Care Act is scuttled, we’d see the opposite happen. Those numbers would go back up. The Urban Institute predicts a whopping 227.3% increase in the uninsured.

Our final state? Here’s a clue: coal miners.

1. West Virginia

West Virginia would be hit hardest if the Affordable Care Act is repealed. | iStock.com

If you guessed West Virginia, congratulations.

West Virginia voted for Trump by a higher margin than any other in the country. And like other states we’ve discussed, it’s akin to shooting itself in the foot when it comes to health care. If the Affordable Care Act is scrapped and a Republican replacement installed, the number of uninsured people in West Virginia could increase almost 300% — the biggest jump in the country.